As Nigeria grapples with rising infections caused by the second wave of the COVID-19 pandemic, a team of international public health researchers have revealed that the lockdown and restrictions imposed in the country between March and May 2020 may have averted not less than 5.8 million infections.
The team of researchers, drawn from the United States, South Africa and Nigeria, said their findings “support the use of restricted mobility as a measure for infection control in Nigeria”.
They, however, pointed out that, even during the lockdown and restrictions, noticeable spikes in people’s movement occurred on Saturdays and Sundays which could be attributed to social events such as parties (or Ówàmbē in a local dialect) and religious activities.
The research findings, which are based on information from confirmed COVID-19 cases provided by the Nigeria Centre for Disease Control (NCDC) from February 27 to July 21, 2020 and Nigeria specific mobility data from Google in same period, was published by public health journal JAMA Network Open.
The researchers are drawn from institutions in the United States (i.e., Parexel International, Harvard university and Holly Hill hospital), South Africa (i.e., Sefako Makgatho Health Sciences University) and Nigeria (i.e., Benue State University as well as Universities of Ibadan, Lagos and Calabar).
The researchers explained that their work was motivated by the need to better understand how the lockdown affected peoples’ movement and community spread of COVID-19: this information could inform future public health responses to subsequent waves of COVID-19.
“Our study goals were to measure the association of government-mandated closures and restrictions with aggregate mobility, to evaluate associations between aggregate mobility and number of individuals with laboratory confirmed SARS-COV-2 infections and to estimate the number of SARS COV-2 infections that may have been averted.”
They observed that the World Health Organisation (WHO) Director General, Dr Tedros Adhanom Ghebreyesus, had on January 30, 2020 declared the COVID-19 outbreak a public health emergency of international concern, asking all countries to prepare for containment, active surveillance, early detection, isolation, case management and contact tracing.
“Most countries including Nigeria (Africa’s largest economy and the most populous country), responded accordingly, and part of the Nigerian government response included socio-economic and public health interventions to reduce impact of the pandemic.
“Socio-economic interventions included providing cash transfers, lines of credit and food assistance to poor and high-risk households, while public health interventions included government-mandated closures and restrictions on schools, social gatherings and all forms of transportation (locally referred to as lockdown).
The closures and restrictions were initiated on March 30, 2020 and partially eased on May 4, 2020. The researchers used sophisticated statistical techniques to analyse NCDC data on daily infection counts, anonymised Google mobility data from Nigeria (covering about 40 million individuals who activated location history on their smartphone google accounts), and publicly available information on the lockdown (e.g., dates for initiating and partially easing the lockdown).
The cross-sectional study found that government-mandated closures and restrictions in Nigeria owing to COVID-19 was associated with significantly reduced aggregate mobility everywhere (except in residential areas) and may have averted up to 5.8 million coronavirus infections.
Additionally, they found that community spread of COVID-19 in Nigeria may have been faster in residential areas, transit stations (e.g., motor parks) and workplaces (including likely venues of social events).
While stressing that “our findings support the use of restricted mobility as a measure of infection control in Nigeria should there be additional COVID-19 waves in the future”, the researchers pointed out that “restrictions on movement are unsustainable in the long term, and that “future closure and restrictions, if warranted, need to be more effective.
“Suggested areas of improvement include tougher restrictions on movement and more robust contact tracing in residential areas, transit hubs and workplaces, greater testing capacity and more political support for testing; greater access to COVID-19 data for policy and process evaluation to identify opportunities for efficiency gains: and more personal responsibility above and beyond the public health campaign dubbed the three Ws, that is washing hands (or using hand sanitiser regularly), wearing a cloth mask over the nose and mouth, and waiting six feet apart (or social distancing).”